Does hormone therapy increase the risk of falls?

This study examined the relationship between androgen deprivation therapy (ADT) and the risk of falls. Authors present preliminary evidence suggesting that patients receiving ADT may be at increased risk of falls.

ADT is a type of hormone therapy commonly used to treat advanced prostate cancer. By reducing the levels of male sex hormones active in prostate cancer (such as testosterone), cancer progression can be delayed and survival increased. ADT involves either the surgical removal of the testicles or drug therapy.

However, ADT causes significant side effects in some patients. ADT can affect bone health, muscle mass, heart health, and metabolic factors (such as weight gain, cholesterol levels, and diabetes risk). Previous reports have indicated that ADT drug therapy increased fat mass by 10% and decreased lean body mass by 3%. This reduced muscle mass may increase the risk of falls. 

The aim of this study was to examine the relationship between ADT and the risk of falls.

1,748 men with prostate cancer were included in this study. 886 of these men were treated with ADT drug therapy. The average duration of ADT was 524 days. 862 men did not receive ADT (control group). The rate of medical diagnoses of falls over 3 years was compared between the two groups.

Overall, men undergoing ADT were 95% more likely to have a serious fall over a 3-year period than men in the control group. This analysis accounted for age, location, monthly income, urbanization level, and other medical conditions (including high blood pressure, diabetes, high cholesterol, heart disease, Parkinson’s disease, epilepsy, stroke, and mental illness).

Authors concluded that patients receiving ADT may be at increased risk of falls. 

No information was provided regarding the treatment given to men in the control group. Factors such as height and weight, physical activity, alcohol consumption, substance abuse, and environmental risk factors were also not accounted for.